Archive for The Month of September, 2007

Archive for the Month of September, 2007

Welcome to the medical billing blog archive for the month of September, 2007.

Here you will find links to every article added to the Outsource Management Group web site during the month of September, 2007.

You can browse this month's archives by clicking the "More" button from any of the excerpts below.

Break Out Well-Woman-Care Visits For Better Reimbursements

A little known fact about well-woman care is that in many cases, you can break out the breast exam and pap smear and realize a reimbursement for both procedures if the patient is covered by Medicare. If the physician provides a complete well-woman exam for a Medicare patient, you should report G0101 (Cervical or vaginal cancer screening; pelvic and clinical breast examination) for the breast and pelvic exams. When the physician also obtains a Pap smear, use Q0091 (Screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory)and this will enable your practice to realize a reimbursement for both services. Just make sure that you have

By: Melissa Clark, CCS-P, RT - CEO
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Taking the Headache Out of Credentialing

Are you swamped? So overwhelmed with patients, billing, invoices, emergencies and other day to day practice worries that you don’t even have the time to get yourself credentialed with all the carriers possible. No one has to tell you that the more insurances you accept, the more patients you can see and the more revenue you can generate for your practice. Credentialing is the key. Did you know your medical billing partner can take some of the heat off you and not only compile and submit your medical billing, they can also get your practice credentialed with any carrier you choose. If you have a busy practice, you may be

By: Melissa Clark, CCS-P, RT - CEO
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Servicing Hospitals? Know Your CCR

Your provider number has a strong impact on your medical billing cost to charge ratio (CCR). If your hospital is merging with another hospital, it is important to figure in the possibly new Cost to Charge Ratio medical billing payments you will receive. There are two avenues merging hospitals can take. The first method is when two hospitals merge together while one of the existing provider numbers is kept in tact. In this instance, one hospital keeps their medical billing number, while the other one drops theirs and joins the first. The hospital that drops their medical billing provider number will receive a new cost to charge ratio. The ratio

By: Melissa Clark, CCS-P, RT - CEO
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Digit Removal Medical Billing Questions

Just when you got a handle of medical billing, another policy throws a curve ball at you. In some instances, the same CPT code is used for two different procedures. An example of this is when performing both and extra digit removal and a skin tag removal. The same medical billing CPT code, 11200, would be used in both of these instances. The medical billing code 11200 means, removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions. This means that if an individual needs an extra digit AND a skin tag removed, than you would use 11200 to report both. To let the payers

By: Melissa Clark, CCS-P, RT - CEO
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Getting the Indirect Supervision Code Right in Three Steps

For help with performing the care plan oversight services if you are having a hard time with the 993xx series these steps should help to get you started. Step one is to count these care services as 99374-99380. The 993xx series codes allows pediatricians to bill for coordination of care of special needs children without face to face visits. You can report these care plan oversight CPO codes as 99374-99380 for Doctor supervision. This is only for when the patient is not present for the following doctors services, a) revision or development of care plans for multidisciplinary and complex modalities. b) related lab and other studes review c) patient status

By: Melissa Clark, CCS-P, RT - CEO
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434.91 – Stroke – Hemorrhage or Both?

When using 434.91 make sure you take all of the specifics into account. When a doctor says that a patient has had a stroke make sure that you know all of the details of the situation or else some procedures can be hard to justify and therefore your medical billing reimbursement may be denied. In the past for diagnosis of a stroke the ICD-9 index listed 436, which is acute but ill defined cerebrovascular disease, as the code to use. Now the index has code 434.91 as the code to use. This is cerebral artery occlusion, unspecified with cerebral infarction. The new ICD-9 index automatically translates a doctors diagnosis of

By: Melissa Clark, CCS-P, RT - CEO
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Confused When to Use Fetal NST Code 59025?

The time to use 59025 to code a fetal non-stress test is when the patient records that she has felt the baby moving. If not then the fetal monitor is counted as routine. What makes the NST Code True? When you use the code 59025 for the fetal non-stress test for NST procedures you must make sure you are using them correctly. How that happens is that during the NST procedure the ob-gyn evaluates the patient and evaluates the well being of the fetus with out the use of IV medications. The test lasts for approximately 30-40 minutes, and the ob-gyn monitors the heart rate of the fetus using external

By: Melissa Clark, CCS-P, RT - CEO
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Get Top Reimbursements for Skin Graft Procedures

In 2006 several changes were made to the CPT regarding skin graft procedures and this included the retiring of several codes and the addition of 37 new skin graft codes to make identifying the procedures more exact for medical billing claims. The skin graft section was also renamed to Skin Replacement Surgery and Skin Substitutes. There are new codes for autografts, sections 15100 through 15261, allografts, sections 15170 through 15176 and xenografts, sections 15400 through 15431. These codes seem to have been created in order to represent some new procedures and techniques. Many of these new codes are also specific to a particular technology or product make sure that your

By: Melissa Clark, CCS-P, RT - CEO
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